Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

Support for this project was provided by Contract/Grant No. 042024 between the National Academy of Sciences and The Robert Wood Johnson Foundation. The views presented in this report are those of the Institute of Medicine Committee on Educating Public Health Professionals for the 21st Century and are not necessarily those of the funding agencies.

Library of Congress Cataloging-in-Publication Data

Who will keep the public healthy? : educating public health professionals for the 21st Century / Kristine Gebbie, Linda Rosenstock, and Lyla M. Hernandez, editor(s).

For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu.

Copyright 2003 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America.

The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

THE NATIONAL ACADEMIES

Advisers to the Nation on Science, Engineering, and Medicine

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Wm. A. Wulf is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. Wm. A. Wulf are chair and vice chair, respectively, of the National Research Council.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

REVIEWERS

This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the NRC’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:

Thomas W. Valente, Ph.D., Director, Master of Public Health Program, Keck School of Medicine, University of Southern California

Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its release. The review of this report was overseen by M. Donald Whorton, M.D., M.P.H., WorkCare, Inc., Alameda, CA, appointed by the Institute of Medicine and Harold J. Fallon, M.D., IOM Home Secretary and Dean Emeritus, School of Medicine, University of Alabama at Bir-

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

mingham, appointed by the NRC’s Report Review Committee, who were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Acknowledgments

Many people willingly shared their expertise and insights with the committee and staff during the course of this study. Their contributions invigorated committee deliberations and enhanced the quality of this report.

William L. Roper, M.D., M.P.H., conceived the idea to examine public health professional education in the 21st century, thereby prompting this study. The committee expresses its appreciation to the Robert Wood Johnson Foundation (RWJF) for sponsoring the study and, in particular, to Pamela Williams Russo, M.D., M.P.H.

Elizabeth Fee, Ph.D., commissioned to write a paper on the history of public health education in the United States, provided a tremendously thorough and extremely readable paper that elucidated for the committee the issues, events, and evolution of public health education over the past century. Additionally, her comments on an earlier draft of this report were informative and helpful in clarifying ideas. The commissioned paper by James C. Thomas, M.P.H., Ph.D., on teaching public health ethics highlighted issues of critical importance to public health education and contributed greatly to the committee’s examination of the role of ethics in public health education.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

City Health Officials, and the Public Health Foundation for their thoughtful and detailed input about the challenges facing public health and the educational needs of public health professionals.

The Association of Schools of Public Health was also helpful in reviewing and distributing a committee survey. Their participation was critical to the successful conduct of this survey on progress made by schools of public health in implementing recommendations of the 1988 Institute of Medicine (IOM) report, The Future of Public Health. The committee is grateful to the 25 schools of public health at the following universities that took the time and put forth the effort to complete the survey:

Boston University

Emory University

Harvard University

Johns Hopkins University

Ohio State University

Saint Louis University

San Diego University

Texas A&M University

Tulane University

University of Alabama, Birmingham

University of Albany (SUNY)

University of California, Berkeley

University of California, Los Angeles

University of Massachusetts

University of Iowa

University of Medicine and Dentistry of New Jersey

University of Michigan

University of Minnesota

University of North Carolina, Chapel Hill

University of Oklahoma

University of Pittsburgh

University of South Carolina

University of Texas, Houston

University of Washington

Yale University

The work of this committee has been informed by several high quality IOM reports on relevant topics including: The Future of Public Health (1988); Linking Research and Public Health Practice: A Review of CDC’s Program of Centers for Research and Demonstration of Health Promotion and Disease (1997); America’s Vital Interest in Global Health (1997); Promoting Health: Intervention Strategies from Social and Behavioral Research (2000); Health and Behavior: the Interplay of Biological, Behavioral, and Societal Influences (2001); and Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care (2002). We acknowledge our indebtedness to the committees and staffs of these reports.

The committee was extremely fortunate in their staffing for this study. We wish to thank our study director, Lyla M. Hernandez, for her enormous effort in producing a clearly written, well-organized report that reflects the collective thought of the committee. Our appreciation also goes to Makisha Wiley for her administrative support, coordination of committee meetings, and maintenance of project files, and to Marc Ehman who provided research assistance throughout the initial phases of the project.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Who Will Keepthe Public Healthy?

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Suggested Citation:"Front Matter." Institute of Medicine. 2003. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press. doi: 10.17226/10542.

Bioterrorism, drug--resistant disease, transmission of disease by global travel . . . there’s no shortage of challenges facing America’s public health officials. Men and women preparing to enter the field require state-of-the-art training to meet these increasing threats to the public health. But are the programs they rely on provide the high caliber professional training they require?

Who Will Keep the Public Healthy? provides an overview of the past, present, and future of public health education, assessing its readiness to provide the training and education needed to prepare men and women to face 21st century challenges. Advocating an ecological approach to public health, the Institute of Medicine examines the role of public health schools and degree--granting programs, medical schools, nursing schools, and government agencies, as well as other institutions that foster public health education and leadership. Specific recommendations address the content of public health education, qualifications for faculty, availability of supervised practice, opportunities for cross--disciplinary research and education, cooperation with government agencies, and government funding for education.

Eight areas of critical importance to public health education in the 21st century are examined in depth: informatics, genomics, communication, cultural competence, community-based participatory research, global health, policy and law, and public health ethics. The book also includes a discussion of the policy implications of its ecological framework.

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